Clinical outcomes of dexamethasone-eluting stent implantation in ST-elevation acute myocardial infarction

Catheter Cardiovasc Interv. 2007 Oct 1;70(4):492-7. doi: 10.1002/ccd.21131.

Abstract

Objectives: The aim of our study was to evaluate the safety and midterm clinical results of dexamethasone-eluting stent (DexES) implantation in ST-segment elevation acute myocardial infarction (STEMI).

Background: Inflammation plays a pivotal role in both inestabilization of coronary atherosclerotic plaques and development of restenosis after stent placement. Antiinflammatory agents may attenuate those mechanisms and improve clinical outcomes. There is little information about clinical results of DexES and no data are available about their utilization during percutaneous coronary intervention (PCI) in STEMI.

Methods: Consecutive patients with STEMI that underwent primary or rescue PCI in our institution were treated with DexES. Clinical follow-up with routine realization of noninvasive test for detection of myocardial ischemia and coronariography if necessary, were performed. The objective of the study was to evaluate the rate of MACE (death, reinfarction, or target lesion revascularization) during midterm follow-up.

Results: The procedure was successful in 96.7% of cases. There were no in-hospital deaths or reinfarctions. One acute stent thrombosis occurred and no subacute thrombosis were observed. During a mean follow-up period of 384 days, cardiac-related death was 1.1%, there were no reinfarctions or late stent thrombosis and target lesion revascularization rate was 4.2%.

Conclusion: We conclude that utilization of DexES for PCI in STEMI is safe and provides good midterm clinical outcomes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / adverse effects
  • Cardiovascular Agents / administration & dosage*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Dexamethasone / administration & dosage*
  • Dexamethasone / adverse effects
  • Drug-Eluting Stents*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / mortality
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Secondary Prevention
  • Stroke Volume
  • Thrombosis / etiology
  • Thrombosis / prevention & control
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left
  • Ventricular Pressure

Substances

  • Anti-Inflammatory Agents
  • Cardiovascular Agents
  • Dexamethasone